(Editors note: we welcome Joseph Quesnel to the Straight Talk blog for his first post. Joseph will be a regular contributor, primarily writing about Aboriginal issues.)

A debate in Australia over a new royal commission looking into young Aboriginal detainees has implications for Canada. How ought we best to deliver social services to indigenous communities, including healthcare?

That debate has relevance here in Canada and the Atlantic region. In one recent column in the Australian by Matthew Cooke – chairman of the National Aboriginal Community Controlled Health Organisation – it was asserted Aboriginal self-determination be “front and centre” in the debate over indigenous health care because it is assumed that model works.

North American indigenous research confirms that. The influential and empirically-based Harvard Project on American Indian Economic Development has stated that “sovereignty matters,” as far as successfully run Indigenous communities go. The researchers concluded that, “When Native nations make their own decisions about what development approaches to take, they consistently out-perform external decision makers.”

That mainly Native American observation also applies in Canada. The government of Canada, through Health Canada, works on First Nation reserves to deliver healthcare, but always looks for ways to transfer control of these health programs to indigenous communities. Australia’s model of indigenous health care delivers results. National Aboriginal Community Controlled Health Organisations (or NACCHOs) allow governments to channel Aboriginal grant money to communities and is making progress on infant and overall mortality rates. But, these Australian entities have clear targets for improvement. If indigenous communities in Canada receive control over health, they need to be accountable for results. That is the trade-off.

Some quantitative opinion data by the Frontier Centre for Public Policy confirms this trend. In 2010, residents of the self-governing Nisga’a Nation in B.C. were asked how autonomy has improved services. A majority of respondents said health services improved.

First Nations people on reserve have some of the worst health indicators in Canada. For example, despite some improvements, First Nations and Metis are still several years behind other Canadians in life expectancy at birth. See the graph above, drawing from Statistics Canada data.

It’s time bands in Canada and the Atlantic region look into better autonomous models.